Anxiety and Fear of Breast Cancer Patients During and After the COVID-19 Era

Gianluca Vanni; Marco Materazzo; Marco Pellicciaro; Jonathan Caspi; Ilaria Portarena; Federico Tacconi; Annalisa Noce; Valentina Enrica Marsella; Alessandra Vittoria Granai; Chiara Adriana Pistolese; Oreste Claudio Buonomo

doi:10.21873/anticanres.16500

Anxiety and Fear of Breast Cancer Patients During and After the COVID-19 Era

Anticancer Res. 2023 Jul;43(7):3255-3263. doi: 10.21873/anticanres.16500.

Authors

Affiliations

¹ Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy.
² Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy; mrcmaterazzo@gmail.com marco.materazzzo@ptvonline.it.
³ PhD Program in Applied Medical-Surgical Sciences, Breast Oncoplastic Surgery, University of Rome Tor Vergata, Rome, Italy.
⁴ Department of Oncology, Policlinico Tor Vergata University, Rome, Italy.
⁵ Division of Thoracic Surgery, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy.
⁶ UOC of Internal Medicine-Center of Hypertension and Nephrology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
⁷ Department of Diagnostic Imaging and Interventional Radiology, Molecular Imaging and Radiotherapy, Policlinico Tor Vergata University, Rome, Italy.
⁸ Faculty of Medicine, Catholic University "Our Lady of Good Counsel", Tirana, Albania.

PMID: 37351959
DOI: 10.21873/anticanres.16500

Abstract

Background/aim: Coronavirus-19 (COVID-19) pandemic had a huge impact on medical resource allocation. While it is clear that the surgery refusal rate of patients with breast cancer (BC) was higher during the pandemic, long-term effect of COVID-19 pandemic on hospital admission in the post-pandemic period has not been fully evaluated. This study aimed to estimate how patients' behavior changed following the pandemic and whether the cross-infection risk is still influencing patients' decision-making process.

Patients and methods: Between the 16^th of January and 18^th of March 2020, between 19^th of March 2020 and the 20^th of March 2020, and between 19^th of March 2023 and the 20^th of March 2023, 266 patients were enrolled and divided into PRE-COVID-19, COVID-19, and POST-COVID-19 groups, respectively. A total of 137 patients with a suspected breast lesion (SBL) were divided into 3 groups: PRE-COVID-19-SBL, COVID-19-SBL, and POST-COVID-19-SBL groups. In addition, 129 BC patients were divided into PRE-COVID-19-BC, COVID-19-BC and POST-COVID-19-BC groups. Patient characteristics including age, marital status, SBL/BC diameter, personal and family history of BC, clinical stage and molecular subtype were recorded. Procedure refusal (PR) and Surgical refusal (SR) were also recorded with their reason.

Results: BC and SBL analysis showed no difference in pre-treatment characteristics (p>0.05). While higher rate of PR and SR rates were reported in COVID-19-SBL and COVID-19-BC groups when compared with PRE-COVID-19 (p=0.003, p=0.013, respectively) and POST-COVID-19 (p=0.005, p=0.004, respectively) groups, no statistical difference was found between PRE-COVID-19 and POST-COVID-19 subanalysis.

Conclusion: Thanks to preventive measures, COVID-19 does not currently seem to affect the decision-making process of patients with BC.

Keywords: Breast neoplasm; COVID-19; SARS-SOV-2; anxiety; breast cancer; decision-making process; surgery; surgery refusal.

MeSH terms

Anxiety
Breast Neoplasms* / pathology
Breast Neoplasms* / surgery
COVID-19* / epidemiology
Fear
Female
Humans
Pandemics
SARS-CoV-2